Save a life

Infections – we all get them, and astoundingly, many people will die from them. But, you’d never think that we’d get them in the hospital while being treated for another illness. Or see the needless loss of life of a newborn baby because of an infection in a nursery.

Some individuals will become infected in an ambulatory care facility. These infections are called health-care-associated infections (HAIs), also referred to as hospital acquired infections.

HAIs are a serious and pervasive issue afflicting our health care system. According to the Centers for Disease Control and Prevention (CDC), HAIs are estimated to be one of the top 10 causes of death in the US, totaling 100,000 per year. That means more patients die of HAIs than from HIV/AIDS (60,000 per year) and automobile accidents (40,000 per year). Specifically, central-line infections occur in 250,000 people a year in the US, and are fatal between 5% and 28% percent of the time.

HAIs are very costly, should be mostly preventable, and everyone – patients, employers, hospitals and even state and federal government (Medicare) – bears the burden of these costs. It is reported that HAIs add as much as $20 billion in additional costs to the health care industry. In 2005, the average payment for a hospitalization in Pennsylvania was over six times higher for patients who contracted a hospital-acquired infection than for patients who did not acquire infections, according to a report by the Pennsylvania Health Care Cost Containment Council. Moreover, a 2007 study of 1.69 million patients who were discharged from 77 hospitals found that the additional cost of treating a patient with an HAI averaged $8,832. This is alarming when data show that Medicare, alone, the federal health insurance program for persons over 65, paid for over one-third of all hospital costs in 2005, according to the American Hospital Association.

Ironically, the Federal Office for Human Research Protections shut down a Michigan HAI project, even as it proved itself to be effective. I think it is time for Congressional action.

Can we reduce HAIs? The leading hospitals in the nation successfully tackling them are Allegheny General Hospital in Pittsburgh, Johns Hopkins in Baltimore, and a consortium of hospitals in Michigan. Allegheny, under Dr. Jerome Granato’s leadership the past five years, and with support from Dr. Peter Perreiah of the Pittsburgh Regional Health Initiative, reduced central-line HAIs by 90% in two years, and sustained a 15 month period in their ICU with no infections.

In this state, the Puget Sound Health Alliance (Alliance), a regional consortium of employers, providers, health plans, unions, and patients aimed at improving the quality of health care in Puget Sound, has made HAIs a priority (www.pugetsoundhealthalliance.org). An Alliance workgroup recommends “highlighting the incidence of hospital acquired infections to lower their occurrence and resulting costs to the system.” The Alliance is currently working with the State Department of Health to make the data more transparent and more consumer-friendly, and will include HAI outcomes data in future reports of its own Community Checkup Report (www.wacommunitycheckup.org). The Alliance is also researching how it can help accelerate current HAI efforts in the Puget Sound region using the proven interventions from Pittsburgh and Johns Hopkins.

Mirroring national efforts, the Washington State Hospital Association (WSHA) and Washington State have been engaged in patient safety efforts. Washington was the first state to get all its hospitals participating in Institute for Healthcare Improvement’s 100,000 Lives Campaign. WSHA is actively engaged in national efforts in addition to its own effort, which includes providing technical assistance to hospitals and disseminating posters and brochures to promote hand washing and staff training. Washington State, in 2007, passed SB1106 to mandate public reporting of certain HAIs beginning in January 2009. A phased-in approach, in July 2008, all hospitals were required to start collecting and reporting all central line-associated infections in ICUs. (When this data will be available to the public has not yet been determined.)

We know what works, as evidenced by efforts in Pittsburgh, Baltimore, and Michigan, and now it’s our turn to implement these best practices here and work with the federal government to break down barriers to efforts that will save patients’ lives. It is imperative that we publicly report the incidence of health care associated infections by facility in King County and the State of Washington, in order to shed light on the problem and save lives.

Related information

6 responses to “Save a life

  1. As the only consumer to ever sit on the WSHA patient safety committee and an active consumer advocate at the PSHA I fully support tracking not only hospital acquired infections but utilizing a community based systemic approach to tracking and eliminating MRSA infections as well.

    Often people acquire these infections while in the County Jail and are then moved via our EMS system into local hospitals but we need a system to track these patients across multiple systems.

    Today in the Wall Street Journal Health Blog, they reported in an article – California Mandates More Screening, Reporting of Hospital Infections” that California, Governor Schwarzenegger (who had veoted a similiar bill four years ago) passed two bills to require hospitals to report and track infection rates and gives public health the resources to do so.

    One of the bills requires hospitals to screen high-risk patients for MRSA infections within 24 hours of admission. (MRSA is a virulent, increasingly common form of staph that’s resistant to most antibiotics.) It will also make hospitals report their infection rates.

    The other bill requires more training on infection control training at hospitals, and adds to the state’s program for monitoring hospital infections.

    Once you reach a critical mass of screening high risk patients for these infections (coupled with prevention measures) you actually have a strong business case for the county to save money by investing in public health measures.

    Who would want to have a loved one get a MRSA infection after being treated by the local fire dept after a MRSA patient who hadn’t been identified was transported in the same unit? (the bacteria can spread from patient to patient through unsterile clothing, ventilation systems, surgical equipment or room furnishings. If they get into a patient’s body, they can be fatal.) Children are especially vulnerable.

    Sherry Reynolds
    Alliance4Health

  2. Connecticut had a similar bill passed in 2006. With many representatives, congressmen, the public and some non-profit organizations that represent survivors of HAI, or survivors themselve were present during the signing of the bill. Unfortunately, the big business hospital, felt it would be to expensive to create a program to make public the amount and type of HAI, they said it just not work out. They had a different way of doing things. So, in Connecticut the HAI are still on the rise.

  3. Sherry,
    I’m a little bias because of my involvement professionally, but on a more personnel note I have felt the sting of a MRSA infection and I to believe it is preventable or at the very least flagable for faster and more appropriate treatment.
    “M”

  4. Some individuals will become infected in an ambulatory care facility. These infections are called health-care-associated infections (HAIs), also referred to as hospital acquired infections

  5. Maybe we should be concentrating on the hundreds of thousands of people who die both inside and outside of hospitals due to the mistakes of physicians!

    I’ve caught some of their mistakes MYSELF! Luckily I was aware and awake enough to stop the errors before it was too late! Of course, I always find myself arguing with a “health care professional”!!

    Those errors kill more than MRSA infections.
    We can learn to spot MRSA, and we can learn to treat MRSA, but learning how to survive the Medical Profession is Something Else!!

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